NR 224 / NR224 Exam 1 | Complete Exam Question
Bank with Verified Correct Answers and Detailed
Rationales | Latest Update (New 2026/2027 Edition) -
Chamberlain | Already Graded A+
SECTION 1: CRITICAL THINKING & NURSING PROCESS
Question 1
While assessing a patient, the nurse observes the patient's IV line is not infusing at the ordered
rate. The nurse assesses the patient for pain at the IV site, checks the flow regulator on the
tubing, looks to see if the patient is lying on the tubing, checks the point of connection between
the tubing and the IV catheter, and then checks the condition of the site where the IV catheter
enters the patient's skin. After the nurse readjusts the flow rate, the infusion begins at the correct
rate. This is an example of:
A. Inference
B. Diagnostic reasoning
C. Competency
D. Problem solving
Answer: D. Problem solving
Rationale: Problem solving involves systematically identifying a problem and taking steps to
resolve it. The nurse methodically assessed multiple potential causes of the IV not infusing (pain
at site, flow regulator, tubing obstruction, connection, insertion site) and then corrected the flow
rate, demonstrating a step-by-step problem-solving approach.
Question 2
The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient reports she
is unable to sleep, feels very fatigued during the day, and is having trouble at work. The nurse
asks her to clarify the type of trouble. The patient explains she can't concentrate or even solve
simple problems. The nurse records the results of the assessment, describing the patient as
having ineffective coping. This is an example of:
A. Diagnostic reasoning
B. Competency
pg. 1
,C. Inference
D. Problem solving
Answer: A. Diagnostic reasoning
Rationale: Diagnostic reasoning is the process of analyzing health data and drawing conclusions
to identify diagnoses. The nurse gathered assessment data (sleep issues, fatigue, trouble
concentrating), interpreted the findings, and formulated a nursing diagnosis (ineffective coping).
Question 3
A patient on a surgical unit develops sudden shortness of breath and a drop in BP. The staff
respond, but the patient dies 30 minutes later. The manager on the nursing unit calls the staff
involved in the emergency response together. The staff discusses what occurred over the 30
minute time frame, the actions taken, and whether other steps should have been implemented.
The nurses in this situation are:
A. Problem solving
B. Showing humility
C. Conducting reflective practice
D. Exercising responsibility
Answer: C. Conducting reflective practice
Rationale: Reflective practice involves thinking back on a situation to analyze actions,
decisions, and outcomes to improve future practice. The staff is reviewing the emergency
response, what occurred, what was done, and what could have been done differently.
Question 4
A nurse has worked on an oncology unit for 3 years. One patient has become visibly weaker and
states, "I feel funny". The nurse knows how patients often have behavior changes before
developing sepsis when they have cancer. The nurse asks the patient questions to assess thinking
skills and notices the patient shivering. The nurse goes to the phone, calls the physician, and
begins the conversation by saying, "I believe that your patient is developing sepsis. I want to
report symptoms I'm seeing." What examples of critical thinking concepts does the nurse show?
(Select all that apply)
A. Experience
B. Ethical
C. Analyticity
D. Self-confidence
E. Risk taking
pg. 2
,Answer: A, C, D
Rationale: The nurse demonstrates Experience (3 years on oncology unit, knows behavior
changes precede sepsis), Analyticity (systematically assesses thinking skills and observes
shivering), and Self-confidence (confidently calls physician and states belief that sepsis is
developing).
Question 5
A nurse who is working on a surgical unit is caring for four different patients. Patient A will be
discharged home and is in need of instruction about wound care. Patients B and C have returned
from the operating room within an hour of each other, and both require vital signs and
monitoring of their intravenous (IV) lines. Patient D is resting following a visit by physical
therapy. Which of the following activities by the nurse represent(s) use of clinical decision
making for groups of patients? (Select all that apply)
A. Consider how to involve patient A in deciding whether to involve the family caregiver in
wound care instruction
B. Think about past experience with patients who develop postoperative complications
C. Decide which activities can be combined for patients B and C
D. Carefully gather any assessment info and identify patient problems
Answer: A, C
Rationale: Clinical decision making for groups involves prioritizing and organizing care.
Considering patient A's involvement in care decisions (A) and deciding which activities can be
combined for patients B and C (C) demonstrate clinical decision making. (B) is reflective
thinking and (D) is assessment, not decision making for groups.
Question 6
The surgical unit has initiated the use of a pain-rating scale to assess patients' pain severity
during their postoperative recovery. The registered nurse (RN) looks at the pain flow sheet to see
the pain scores recorded for a patient over the last 24 hours. Use of the pain scale is an example
of which intellectual standard?
A. Deep
B. Relevant
C. Consistent
D. Significant
Answer: A
Rationale: Using a standardized pain scale to track scores over time allows the nurse to see
pg. 3
, deeper patterns in the patient's pain experience, which represents the intellectual standard of
thoroughness or depth in assessment.
Question 7
During a home health visit the nurse prepares to instruct a patient in how to perform range-of-
motion (ROM) exercises for an injured shoulder. The nurse verifies that the patient took an
analgesic 30 minutes before arrival at the patient's home. After discussing the purpose for the
exercises and demonstrating each one, the nurse has the patient perform them. After two attempts
with only the second of three exercises, the patient stops and says, "This hurts too much. I don't
see why I have to do this so many times." The nurse applies the critical thinking attitude of
integrity in which of the following actions?
A. "I understand your reluctance, but the exercises are necessary for you to regain function in
your shoulder. Let's go a bit more slowly and try to relax."
B. "I see that you're uncomfortable. I'll call your doctor to decide the next step."
C. "Show me exactly where your pain is and rate it for me on a scale of 0 to 10."
D. "Is anything else bothering you? Other than the pain, is there any other reason you might not
want to do the exercises?"
Answer: A
Rationale: Integrity involves being honest and authentic while maintaining professional
standards. The nurse acknowledges the patient's reluctance, validates the pain, but still provides
necessary education and offers a solution (going more slowly), demonstrating integrity in
balancing patient concerns with therapeutic needs.
Question 8
The nurse cared for a 14-year-old with renal failure who died near the end of the work shift. The
health care team tried for 45 minutes to resuscitate the child with no success. The family was
devastated by the loss, and, when the nurse tried to talk with them, the mother said, "You can't
make me feel better; you don't know what it's like to lose a child." Which of the following
examples of journal entries might best help the nurse reflect and think about this clinical
experience? (Select all that apply.)
A. Data entry of the time of day, who was present, and the condition of the child
B. Description of the efforts to restore the child's BP, what was used, and questions about the
child's response
C. The meaning the experience had for the nurse with respect to her understanding of dealing
with the patient's death
D. A description of what the nurse said to the mother, the mother's response, and how the nurse
might approach the situation differently in the future
pg. 4
Bank with Verified Correct Answers and Detailed
Rationales | Latest Update (New 2026/2027 Edition) -
Chamberlain | Already Graded A+
SECTION 1: CRITICAL THINKING & NURSING PROCESS
Question 1
While assessing a patient, the nurse observes the patient's IV line is not infusing at the ordered
rate. The nurse assesses the patient for pain at the IV site, checks the flow regulator on the
tubing, looks to see if the patient is lying on the tubing, checks the point of connection between
the tubing and the IV catheter, and then checks the condition of the site where the IV catheter
enters the patient's skin. After the nurse readjusts the flow rate, the infusion begins at the correct
rate. This is an example of:
A. Inference
B. Diagnostic reasoning
C. Competency
D. Problem solving
Answer: D. Problem solving
Rationale: Problem solving involves systematically identifying a problem and taking steps to
resolve it. The nurse methodically assessed multiple potential causes of the IV not infusing (pain
at site, flow regulator, tubing obstruction, connection, insertion site) and then corrected the flow
rate, demonstrating a step-by-step problem-solving approach.
Question 2
The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient reports she
is unable to sleep, feels very fatigued during the day, and is having trouble at work. The nurse
asks her to clarify the type of trouble. The patient explains she can't concentrate or even solve
simple problems. The nurse records the results of the assessment, describing the patient as
having ineffective coping. This is an example of:
A. Diagnostic reasoning
B. Competency
pg. 1
,C. Inference
D. Problem solving
Answer: A. Diagnostic reasoning
Rationale: Diagnostic reasoning is the process of analyzing health data and drawing conclusions
to identify diagnoses. The nurse gathered assessment data (sleep issues, fatigue, trouble
concentrating), interpreted the findings, and formulated a nursing diagnosis (ineffective coping).
Question 3
A patient on a surgical unit develops sudden shortness of breath and a drop in BP. The staff
respond, but the patient dies 30 minutes later. The manager on the nursing unit calls the staff
involved in the emergency response together. The staff discusses what occurred over the 30
minute time frame, the actions taken, and whether other steps should have been implemented.
The nurses in this situation are:
A. Problem solving
B. Showing humility
C. Conducting reflective practice
D. Exercising responsibility
Answer: C. Conducting reflective practice
Rationale: Reflective practice involves thinking back on a situation to analyze actions,
decisions, and outcomes to improve future practice. The staff is reviewing the emergency
response, what occurred, what was done, and what could have been done differently.
Question 4
A nurse has worked on an oncology unit for 3 years. One patient has become visibly weaker and
states, "I feel funny". The nurse knows how patients often have behavior changes before
developing sepsis when they have cancer. The nurse asks the patient questions to assess thinking
skills and notices the patient shivering. The nurse goes to the phone, calls the physician, and
begins the conversation by saying, "I believe that your patient is developing sepsis. I want to
report symptoms I'm seeing." What examples of critical thinking concepts does the nurse show?
(Select all that apply)
A. Experience
B. Ethical
C. Analyticity
D. Self-confidence
E. Risk taking
pg. 2
,Answer: A, C, D
Rationale: The nurse demonstrates Experience (3 years on oncology unit, knows behavior
changes precede sepsis), Analyticity (systematically assesses thinking skills and observes
shivering), and Self-confidence (confidently calls physician and states belief that sepsis is
developing).
Question 5
A nurse who is working on a surgical unit is caring for four different patients. Patient A will be
discharged home and is in need of instruction about wound care. Patients B and C have returned
from the operating room within an hour of each other, and both require vital signs and
monitoring of their intravenous (IV) lines. Patient D is resting following a visit by physical
therapy. Which of the following activities by the nurse represent(s) use of clinical decision
making for groups of patients? (Select all that apply)
A. Consider how to involve patient A in deciding whether to involve the family caregiver in
wound care instruction
B. Think about past experience with patients who develop postoperative complications
C. Decide which activities can be combined for patients B and C
D. Carefully gather any assessment info and identify patient problems
Answer: A, C
Rationale: Clinical decision making for groups involves prioritizing and organizing care.
Considering patient A's involvement in care decisions (A) and deciding which activities can be
combined for patients B and C (C) demonstrate clinical decision making. (B) is reflective
thinking and (D) is assessment, not decision making for groups.
Question 6
The surgical unit has initiated the use of a pain-rating scale to assess patients' pain severity
during their postoperative recovery. The registered nurse (RN) looks at the pain flow sheet to see
the pain scores recorded for a patient over the last 24 hours. Use of the pain scale is an example
of which intellectual standard?
A. Deep
B. Relevant
C. Consistent
D. Significant
Answer: A
Rationale: Using a standardized pain scale to track scores over time allows the nurse to see
pg. 3
, deeper patterns in the patient's pain experience, which represents the intellectual standard of
thoroughness or depth in assessment.
Question 7
During a home health visit the nurse prepares to instruct a patient in how to perform range-of-
motion (ROM) exercises for an injured shoulder. The nurse verifies that the patient took an
analgesic 30 minutes before arrival at the patient's home. After discussing the purpose for the
exercises and demonstrating each one, the nurse has the patient perform them. After two attempts
with only the second of three exercises, the patient stops and says, "This hurts too much. I don't
see why I have to do this so many times." The nurse applies the critical thinking attitude of
integrity in which of the following actions?
A. "I understand your reluctance, but the exercises are necessary for you to regain function in
your shoulder. Let's go a bit more slowly and try to relax."
B. "I see that you're uncomfortable. I'll call your doctor to decide the next step."
C. "Show me exactly where your pain is and rate it for me on a scale of 0 to 10."
D. "Is anything else bothering you? Other than the pain, is there any other reason you might not
want to do the exercises?"
Answer: A
Rationale: Integrity involves being honest and authentic while maintaining professional
standards. The nurse acknowledges the patient's reluctance, validates the pain, but still provides
necessary education and offers a solution (going more slowly), demonstrating integrity in
balancing patient concerns with therapeutic needs.
Question 8
The nurse cared for a 14-year-old with renal failure who died near the end of the work shift. The
health care team tried for 45 minutes to resuscitate the child with no success. The family was
devastated by the loss, and, when the nurse tried to talk with them, the mother said, "You can't
make me feel better; you don't know what it's like to lose a child." Which of the following
examples of journal entries might best help the nurse reflect and think about this clinical
experience? (Select all that apply.)
A. Data entry of the time of day, who was present, and the condition of the child
B. Description of the efforts to restore the child's BP, what was used, and questions about the
child's response
C. The meaning the experience had for the nurse with respect to her understanding of dealing
with the patient's death
D. A description of what the nurse said to the mother, the mother's response, and how the nurse
might approach the situation differently in the future
pg. 4
